Infection after mini-open rotator cuff repair

Propionobacter acnes Infection as an Occult Cause of Postoperative Shoulder Pain: A Case Series

“…In most clinical laboratories in the United States, conventional cultures are held only for 5 days [19]. Based on our findings and those of others, we recommend cultures be held for at least 14 days [18]. Furthermore, similar to others [15,21], we found intraoperative Gram stains unhelpful in diagnosing P. acnes infection.…”

“…In another series, P. acnes was the major etiology of postoperative septic arthritis, comprising 56% of shoulder infections [26]. Herrera et al [18] in 2002 reported the incidence of deep infection after open rotator cuff repair to be 0.27% to 1.7%. Athwal et al [3] found an incidence of 0.43% after different techniques of rotator cuff reconstructions.…”

“…The incidence of infection after rotator cuff repair ranges between 0.27% to 1.9% [3,18,27,28,37], whereas the incidence after shoulder arthroplasty ranges from 0% and 15.4% [9,11,38,41,44]. Infections after proximal humerus fractures are less common [4,29,32,40,46].…”

“…Infections after proximal humerus fractures are less common [4,29,32,40,46]. P. acnes is being recognized as a causal agent in shoulder infections with increasing frequency [3,7,14,18,33,35,37,39,45]. This nonspore-forming microaerophilic bacillus has a low level of virulence but has been established as a pathogen in endocarditis [30,42], meningitis [5,43], arthritis [23], osteomyelitis [1,31] and spondylitis [10,13].…”

Origin of Propionibacterium in Surgical Wounds and Evidence-Based Approach for Culturing Propionibacterium from Surgical Sites

“…P ropionibacterium species are often grown on culture of specimens obtained at the time of orthopaedic revision surgery. The pathogenicity of this organism has been demonstrated for patients who have undergone shoulder implant surgery [1][2][3][4][5][6][7][8][9][10][11][12][13][14] , hip or knee arthroplasty [15][16][17][18][19][20][21][22] , or spine surgery [23][24][25][26][27][28][29][30][31][32][33][34][35][36][37] . While many cases of Propionibacterium infections are attributed to Propionibacterium acnes, other species of Propionibacterium have been recovered from revision surgical sites 38 .…”